OF THE ALIMENTARY CANAL 117 



invariably to restore the amount of acid to normal. 

 Stenosis of the opening may be followed by a return 

 to the greater acidity. If the HCl is absent, however, 

 the operation will seldom, if ever, cause it to appear. 



That there cannot be any serious loss of power to 

 digest and absorb food-stuffs is shown by the remark- 

 able way in which the great majority of cases operated 

 on become fat and flourishing after gastrojejunostomy 

 for non-malignant affections, the improved condition 

 being maintained for many years. There is at least 

 one patient who at the age of seven was described 

 by his father as strong and healthy, with good appe- 

 tite and exceedingly good digestion, after a gastro- 

 jejunostomy at the age of eight weeks for pyloric 

 stenosis. Paterson has proved that the amount of 

 fat and protein passed in the faeces without assimila- 

 tion is very little greater than in the normal individual. 

 In four cases it was only about 2 per cent above 

 normal ; that is, the faeces contained about 9 to 

 9-5 per cent of protein nitrogen taken as food 

 instead of the normal 77 per cent. Much less 

 favourable results previously pubhshed by Joslin 

 were due to the fact that he used cancerous cases on 

 which to experiment. Paterson' s results are confirmed 

 by Cameron,* who finds that the only ill-effect is some 

 slight diminution in the power of absorbing fat. 



The relief afforded by a gastrojejunostomy in 

 conditions where there is no organic obstruction 

 depends on two main factors : it drains away the 

 acid juice, so that no excess can accumulate, and 



* Brit. Med. Jour., 1908, i, p. 140. 



